The Relationship Between the Severity of Coronary Artery Disease and Epicardial Adipose Tissue Depends on the Left Ventricular Function

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2012 Nov 8

PMID 23133630

Citations 3

Authors

Christina Doesch

Tim Suselbeck

Dariusch Haghi

Florian Streitner

Stefan O Schoenberg

Martin Borggrefe

Theano Papavassiliu

Affiliations

Soon will be listed here.

Abstract

Background: Epicardial adipose tissue (EAT) is an active metabolic and endocrine organ. Previous studies focusing mainly on patients with preserved left ventricular function (LVF) could show a correlation between increased amounts of EAT and the extent and activity of coronary artery disease (CAD). However, to date, there are no data available about the relationship between EAT and the severity of CAD with respect to the whole spectrum of LVF impairment. Therefore, we evaluated this relationship in patients with CAD.

Methods: 250 patients with CAD and 50 healthy controls underwent CMR examination to assess EAT. The severity of CAD was defined using the angiographic Gensini score (GSS).

Results: The GSS ranged from 2-364. Linear regression analysis revealed a significant correlation between EAT and GSS (r = 0.177, p = 0.01). Patients with mild (GSS≤10) and moderate CAD (GSS>10-≤40) showed comparable EAT to healthy controls. However, in patients with severe CAD (GSS>40) EAT was significantly reduced (p<0.0001) compared to healthy controls. Interestingly, patients with the same GSS revealed different EAT depending on the left ventricular function (LVF). Patients with preserved LVF (LVF≥50%) showed more EAT mass compared to those with reduced LVF (LVF<50%) regardless of the GSS. In patients with preserved LVF and mild CAD, EAT was comparable to healthy controls (61.8±19.4 g vs. 62.9±14.4 g, p = 0.8). In patients with moderate CAD, EAT rose significantly to 83.1±24.9 g (p = 0.01) and started to decline to 66.4±23.6 g in patients with severe CAD (p = 0.03). Contrary, in CAD patients with reduced LVF, EAT was already significantly reduced in patients with mild CAD as compared to healthy controls (p = 0.001) and showed a stepwise decline with increasing CAD severity.

Conclusion: The relationship between EAT and the severity of CAD depends on LVF. These findings emphasize the multifactorial interaction between EAT and the severity of CAD.

Citing Articles

The Role of Epicardial Adipose Tissue in Acute Coronary Syndromes, Post-Infarct Remodeling and Cardiac Regeneration.

Krauz K, Kempinski M, Janczak P, Momot K, Zarebinski M, Poprawa I Int J Mol Sci. 2024; 25(7).

PMID: 38612394 PMC: 11011833. DOI: 10.3390/ijms25073583.

Association of epicardial adipose tissue with different stages of coronary artery disease: A cross-sectional UK Biobank cardiovascular magnetic resonance imaging substudy.

van Meijeren A, Ties D, de Koning M, van Dijk R, van Blokland I, Lizana Veloz P Int J Cardiol Heart Vasc. 2022; 40:101006.

PMID: 35372662 PMC: 8971641. DOI: 10.1016/j.ijcha.2022.101006.

Epicardial adipose tissue in long-term hemodialysis patients: its association with vascular calcification and long-term development.

Barros X, Dirrichs T, Koos R, Reinartz S, Kaesler N, Kramann R J Nephrol. 2015; 29(2):241-250.

PMID: 26253562 DOI: 10.1007/s40620-015-0221-1.

References

Thanassoulis G, Massaro J, Hoffmann U, Mahabadi A, Vasan R, ODonnell C . Prevalence, distribution, and risk factor correlates of high pericardial and intrathoracic fat depots in the Framingham heart study. Circ Cardiovasc Imaging. 2010; 3(5):559-66. PMC: 3063852. DOI: 10.1161/CIRCIMAGING.110.956706. View

Sacks H, Fain J . Human epicardial adipose tissue: a review. Am Heart J. 2007; 153(6):907-17. DOI: 10.1016/j.ahj.2007.03.019. View

Doesch C, Suselbeck T, Leweling H, Fluechter S, Haghi D, Schoenberg S . Bioimpedance analysis parameters and epicardial adipose tissue assessed by cardiac magnetic resonance imaging in patients with heart failure. Obesity (Silver Spring). 2010; 18(12):2326-32. DOI: 10.1038/oby.2010.65. View

Ahima R, Flier J . Adipose tissue as an endocrine organ. Trends Endocrinol Metab. 2000; 11(8):327-32. DOI: 10.1016/s1043-2760(00)00301-5. View

Iacobellis G . Epicardial and pericardial fat: close, but very different. Obesity (Silver Spring). 2009; 17(4):625. DOI: 10.1038/oby.2008.575. View

Silaghi A, Piercecchi-Marti M, Grino M, Leonetti G, Alessi M, Clement K . Epicardial adipose tissue extent: relationship with age, body fat distribution, and coronaropathy. Obesity (Silver Spring). 2008; 16(11):2424-30. DOI: 10.1038/oby.2008.379. View

Nesto R . C-reactive protein, its role in inflammation, Type 2 diabetes and cardiovascular disease, and the effects of insulin-sensitizing treatment with thiazolidinediones. Diabet Med. 2004; 21(8):810-7. DOI: 10.1111/j.1464-5491.2004.01296.x. View

Djaberi R, Schuijf J, Van Werkhoven J, Nucifora G, Jukema J, Bax J . Relation of epicardial adipose tissue to coronary atherosclerosis. Am J Cardiol. 2008; 102(12):1602-7. DOI: 10.1016/j.amjcard.2008.08.010. View

Hansson G . Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005; 352(16):1685-95. DOI: 10.1056/NEJMra043430. View

10.

Cerqueira M, Weissman N, Dilsizian V, Jacobs A, Kaul S, Laskey W . Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002; 105(4):539-42. DOI: 10.1161/hc0402.102975. View

11.

Bettencourt N, Toschke A, Leite D, Rocha J, Carvalho M, Sampaio F . Epicardial adipose tissue is an independent predictor of coronary atherosclerotic burden. Int J Cardiol. 2011; 158(1):26-32. DOI: 10.1016/j.ijcard.2010.12.085. View

12.

Mazurek T, Zhang L, Zalewski A, Mannion J, Diehl J, Arafat H . Human epicardial adipose tissue is a source of inflammatory mediators. Circulation. 2003; 108(20):2460-6. DOI: 10.1161/01.CIR.0000099542.57313.C5. View

13.

Silaghi A, Achard V, Paulmyer-Lacroix O, Scridon T, Tassistro V, Duncea I . Expression of adrenomedullin in human epicardial adipose tissue: role of coronary status. Am J Physiol Endocrinol Metab. 2007; 293(5):E1443-50. DOI: 10.1152/ajpendo.00273.2007. View

14.

Rutter M, Meigs J, Sullivan L, DAgostino Sr R, Wilson P . C-reactive protein, the metabolic syndrome, and prediction of cardiovascular events in the Framingham Offspring Study. Circulation. 2004; 110(4):380-5. DOI: 10.1161/01.CIR.0000136581.59584.0E. View

15.

Bland J, Altman D . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1(8476):307-10. View

16.

Reilly M, Lehrke M, Wolfe M, Rohatgi A, Lazar M, Rader D . Resistin is an inflammatory marker of atherosclerosis in humans. Circulation. 2005; 111(7):932-9. DOI: 10.1161/01.CIR.0000155620.10387.43. View

17.

Iacobellis G, Pistilli D, Gucciardo M, Leonetti F, Miraldi F, Brancaccio G . Adiponectin expression in human epicardial adipose tissue in vivo is lower in patients with coronary artery disease. Cytokine. 2005; 29(6):251-5. DOI: 10.1016/j.cyto.2004.11.002. View

18.

Shirani J, Berezowski K, Roberts W . Quantitative measurement of normal and excessive (cor adiposum) subepicardial adipose tissue, its clinical significance, and its effect on electrocardiographic QRS voltage. Am J Cardiol. 1995; 76(5):414-8. DOI: 10.1016/s0002-9149(99)80116-7. View

19.

Khawaja T, Greer C, Chokshi A, Chavarria N, Thadani S, Jones M . Epicardial fat volume in patients with left ventricular systolic dysfunction. Am J Cardiol. 2011; 108(3):397-401. DOI: 10.1016/j.amjcard.2011.03.058. View

20.

. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis. Eur Heart J. 2011; 33(14):1750-7. DOI: 10.1093/eurheartj/ehr254. View